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Application to Request an Exemption from the Cardiopulmonary Resuscitation (CPR) Requirement

This form is not for all applicants. Use this form only if you are physically incapable of performing CPR.

As of January 1, 2009, all dentists must receive and maintain certification in cardiopulmonary resuscitation (CPR). If a dentist is physically unable to perform CPR, he or she may request an exemption by submitting an application for exemption. The request must be accompanied by a statement from the professional treating the disability and a signed assurance naming another individual or individuals who will maintain CPR certification and be present in the office while the exempt dentist is seeing patients.